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I firmly agree with NLIRH that these fixes, particularly to the language on both reproductive rights and immigrants, are crucial to making this reform to our healthcare system fair to all citizens. However, I worry that NLIRH may be misrepresenting the legislative procedure that is likely to be utilized to pass the healthcare bill. Here is the text from the Q&A:

“It is likely that there will be a “technical fixes” bill that will pass afterwards if the health care reform bill passes through reconciliation. The Nelson provision, and provisions relating to immigrant inclusion, may be changed here.”

The health care bill has already passed the Senate with 60 votes. The plan is to pass that bill, normally, in the House and then sign it into law. The “technical fixes” bill that this publication refers to IS the reconciliation bill that will be passed afterwards. And NLIRH is right, under reconciliation Congress probably can’t address reproductive rights, immigration, or territories (though I think VP Biden + 50 Democrats could technically overrule the Senate Parliamentarian and vote that such changes are, in fact, germane to the reconciliation process – unfortunately, the likelihood of such a strong-arm tactic is fairly low).

Again, I firmly agree that these additional changes are very important. However, I worry that there may simply be no avenue by which these changes could be made at this point in the process without 60 votes in the Senate (which I believe the Q&A page readily acknowledges). Of course, maybe 60+ senators will actually see the light on these issues, and agree to pass a “technical fixes bill” including changes to the language on the aforementioned issues, which would eliminate the need for the constraints of reconciliation. I applaud NLIRH for fighting for these unrepresented constituencies, and hope that we can all put pressure on our representatives to make these much-needed changes to the bill. The key procedural fight on these issues, at this point, would be to either force these issues through the reconciliation process or to have the Senate to make all the necessary fixes without reconciliation, with 60 senators standing up for the rights of women, immigrants, and residents of U.S. territories.

We have been hearing that there are plans for a third bill – that is, after the budget reconciliation process through which health care reform leadership has been telling us they can’t “fix” abortion or immigration issues. It would be through that venue that we could advocate for technical fixes. However, that might be very difficult (as you have acknowledged), and we simply cannot rely on promises of future fixes. For this reason, NLIRH cannot support the current proposal – they Hyde Amendment has taught us what “we’ll get to it later” usually means.